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The document discusses the treatment and management of alcohol-associated cirrhosis, emphasizing that abstinence is crucial for improving survival rates. It highlights the potential benefits of Baclofen in reducing cravings and the importance of a multidisciplinary approach for long-term recovery post-liver transplantation. Additionally, it notes that many patients can recover sufficiently to avoid transplantation if they abstain from alcohol, and the traditional 6-month abstinence rule may not significantly impact long-term outcomes.

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4 views3 pages

ا

The document discusses the treatment and management of alcohol-associated cirrhosis, emphasizing that abstinence is crucial for improving survival rates. It highlights the potential benefits of Baclofen in reducing cravings and the importance of a multidisciplinary approach for long-term recovery post-liver transplantation. Additionally, it notes that many patients can recover sufficiently to avoid transplantation if they abstain from alcohol, and the traditional 6-month abstinence rule may not significantly impact long-term outcomes.

Uploaded by

shahdalaasalahmad
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOCX, PDF, TXT or read online on Scribd
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‫التدريب العملي على الترجمة الطبية‬

‫ واألخير‬4 ‫الجزء‬

.‫النص التالي يتحدث عن موضوع تشمع الكبد الكحولي‬


‫يرجى ترجمته بطريقة مفهومًة وواضحًة مع مراعاة‬
‫الشروط والمالحظات المذكورة ضمن الملفات التي‬
.‫أرسلتها على قناة التلجرام‬
‫ أو وضعها‬،‫يمكن وضع الترجمة ضمن ملف وورد جديد‬
‫ أو إرسالها‬،‫تحت النص األصلي في ملف الوورد هذا‬
.‫كرسالة عادية على التلغرام دون ملف وورد‬

- Abstinence is the only treatment that clearly improves survival


in patients with alcohol-associated cirrhosis. All patients should
also receive optimal inpatient and outpatient nutritional
support.

- Baclofen, a gamma aminobutyric acid B-receptor agonist,


shows promise in decreasing craving and improving
abstinence and thus decreasing the likelihood of relapse in
patients with alcohol-associated cirrhosis.

- The goal of intervention should be sustained abstinence,


which improves the histologic features of alcohol-associated
liver injury, reduces portal pressure, and slows progression to
cirrhosis. In two thirds of patients, significant clinical
improvement can be seen within 3 months. Within 2 years,
many patients achieve complete clinical and biochemical
recovery, regain lost muscle mass, and can safely stop
diuretics and other liver-related medicines.
- Alcohol-associated cirrhosis is the second most common
indication for LT in the USA and Europe and is likely to become
the most common in the USA. Important factors that reduce
survival after Liver Transplantation are concurrent HCV
infection, smoking-related cancers, cardiovascular disease, and
a return to destructive patterns of drinking.

Although almost half of the transplant recipients drink some


alcohol after LT, few return to destructive patterns of alcohol
use. A multidisciplinary approach both before and after the
operation, including addiction specialists, psychiatrists, and
transplant professionals, appears to offer the best opportunity
for patients with ALD to achieve long- term high quality of life
after LT.

- Many patients with apparently advanced alcohol-


associated cirrhosis can recover to the degree that LT is not
required if they can abstain from drinking.

- Because the benefits of abstinence can be so dramatic,


requiring a period of abstinence before proceeding with
transplantation is reasonable; however, if patients do not
show evidence of significant recovery within 3 months, they are
unlikely to survive without transplantation. Referral to a
transplant center at that time for further evaluation of their
alcoholism and candidacy for transplantation gives patients the
best opportunity to be placed on the transplant waiting list
after the traditional 6-month abstinence period required by
many transplant centers and insurance companies. This “6-
month rule” was initiated in 1997 to help ensure maximal
hepatic recovery off alcohol and to document sobriety;
however, this arbitrary time limit has not been shown to affect
long-term survival or sobriety.

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